Journal of Research in Orthopedic Science
Volume:4 Issue: 2, May 2017

During a total knee arthroplasty, it is common to make a distal femoral cut based on the femoral mechanical-anatomical angle (FMA), which in most patients is six degrees. However, in patients with a higher FMA, there is not yet a consensus between surgeons regarding the degree of the cutting angle.
The aim of this study is to assess the treatment outcomes of patients with a FMA of more than seven degrees who were treated by distal femoral cuts of six degrees during a total knee arthroplasty.
We retrospectively reviewed the clinical and radiological results of patients who were treated at our center by a conventional valgus cut of six degrees during a total knee arthroplasty and had a FMA of more than seven degrees. A knee society score (KSS) was completed for all patients during follow-up visits.
A total of 31 cases with knee osteoarthritis and a FMA of more than seven degrees were enrolled in this study. The cases consisted of 8 men and 23 women with an average age of 65.41 (range 46 - 77 years) (SD ± 7.61) years and a mean follow-up time of 11.51 months (range 3 - 24 months) (SD ± 6.08). The mean KSS was 148.51 (SD ± 7.43), (range 132 to 167), which is considered good. There was a statistically significant relationship between the lateral distal femoral angle (LDFA) and FMA. However, there was not a statistically significant correlation between LDFA and KSS.
Although the overall alignment of the lower extremity in our patients was in varus, this amount of varus does not prove to have an effect on the outcome.

Knee osteoarthritis (OA) is the most common form of arthritis and is the major cause of pain and disability in the elderly. The relationship between obesity and increased risk of knee osteoarthritis was known for many years. Since then, many studies have shown the relationship between knee osteoarthritis and obesity.
In this study, we tried to evaluate whether compared to weight, the adipose tissue has a stronger correlation with the occurrence of knee osteoarthritis.
In a cross-sectional study that was a part of the Fasa knee osteoarthritis registry (FOAS), 131 patients with OA were sex matched with 262 patients in the control group. Serum samples of the patients, the Western Ontario and McMaster universities arthritis index (WOMAC) questionnaire and demographic data were collected. Leptin and adiponectin as hormones secreted by the adipose tissue were measured.
Weight, body mass index (BMI), and waist circumference (WC) were significantly different between the two groups (P The results of the current study showed that levels of hormones secreted from the adipose tissue, in people with knee OA, were higher compared to the control group, indicating the possible effect of these hormones on the process of osteoarthritis. Finally, we showed that after adjusting for age, sex, and BMI, leptin and adiponectin are significantly correlated with the amount of pain indicating higher levels of leptin and adiponectin lead to increased pain.

Despite several surgical techniques introduced for the treatment of distal radial giant cell tumor (GCT), most appropriate treatments remain to be discovered.
The current study reported on the results of en bloc resection and partial wrist arthrodesis using non-vascularized fibular shaft.
Between 2004 and 2014, 7 patients with distal radial GCT (Campanacci grade III) were treated by en bloc resection and partial wrist arthrodesis using non-vascularized fibular shaft. Arthrodesis was performed using an intramedullary pin. Patients were followed for 59 ± 38 months. At the last visit, active range of wrist motions, modified musculoskeletal tumor society (MSTS) scoring system, instability and grip strength compared to contralateral side were measured. Also, time of union, need for further operations and recurrence of the tumor were evaluated.
After 8.3 ± 0.5 months, complete union was achieved. The ranges of wrist flexion, wrist extension, ulnar deviation, radial deviation, supination, and pronation averaged 16.7 ± 2.6, 7.5 ± 6.1, 7.5 ± 6.1, 6.7 ± 5.2, 33.3 ± 6.8, and 30.8 ± 8.6 degrees, respectively. The mean modified MSTS score was 75.8 ± 8%. Grip strength was 53.3 ± 6.8% of the contralateral side. Graft-related complications did not occur. Recurrence occurred in 2 patients, including one bony recurrence at the graft-wrist junction and one soft tissue recurrence (28.6%).
Replacement of excised distal radius with non-vascularized fibular shaft autograft following en bloc resection and partial arthrodesis, using an intramedullary pin, could serve as an appropriate treatment of distal radial GCT.

Avascular necrosis (AVN) of the capitate is relatively rare. Although there are many factors as etiology; however, there are idiopathic ones.
A 15-year-old female presented with wrist pain without the history of previous major trauma and no relief with conservative management; radiographic evaluation revealed capitates osteonecrosis with collapse and sclerosis. She underwent surgery (curettage of necrotic bone and iliac crest bone grafting). Two years fallow-up showed full recovery clinically and radiographically.
Capitate AVN should be included in the differential diagnosis of wrist pain in pediatric patients. Despite the controversial multiple surgical options to treat capitate osteonecrosis, autogenous iliac crest bone grafting can have a good result, even in the pediatric patient.

Hydatid cyst is a zoonotic disease, affecting humans and other mammals worldwide. It is caused by tapeworms of the genus Echinococcus, which is most frequently encountered in the liver and lungs. Although involvement of the central nervous system and spine is rare, it can lead to severe neurological deficits due to direct compression.
We report a case of intradural extramedullary hydatid cyst in the lumbar region with a sudden onset, causing progressive paraplegia and areflexia over the past 20 days. After surgical removal, the cyst was sent for histopathological examination. The results showed inner laminated membranes and an outer fibrous layer, surrounded by foreign-body giant cells. The primary objective during surgery was to avoid perforation of the cyst, thereby reducing the risk of systemic dissemination and local seeding of the parasite. During the postoperative period, there was a steady improvement in the neurological deficit, and the patient was discharged with anthelmintics to prevent any distant dissemination.
An accurate and precise diagnosis is necessary when dealing with cystic pathologies.

Post-polio syndrome (PPS) can have devastating functional effects on the walking ability of patients decades after the acute disease. Genu recurvatum, as a consequence of PPS, is one such disability which can be treated through different measures.
A 43-year-old woman with a history of supracondylar extension osteotomy of the left femur at the age of 22 was admitted to our hospital for a flexion contracture of the left knee due to poliomyelitis. She was able to walk without assistance for 20 years after the osteotomy until one year ago, when she started to experience progressive genu recurvatum. In the clinical and laboratory workup, she was diagnosed with PPS. Accordingly, we decided to perform supracondylar flexion osteotomy.
Supracondylar flexion osteotomy in patients with genu recurvatum, as a consequence of PPS, is a valuable treatment, which can relieve the patients'' dependence on walking aids and improve their symptoms.